Strengthening the antenatal care programme is suggested as one of the public health strategies to reduce preterm birth burden at a population level. However, the evidence so far available is inconclusive.
To evaluate the association between antenatal care (ANC) visit and preterm birth; and also to explore to what extent the increased usage of ANC after the initiation of the Maternal, Neonatal and Child Health (MNCH) project in Matlab, Bangladesh, contributed to the reduction of preterm birth.
This population-based cohort study was conducted in Matlab, a subdistrict under Chandpur. The analysis was based on data collected from 2005 to 2009. In 2007, an MNCH project was initiated in the area that strengthened the ongoing ANC services.
In total, 12?980 live births with their mothers during the study period were included in the analysis.
We performed logistic regression with generalised estimating equation models to evaluate the associations.
Preterm birth.
The number of ANC visits was associated wi preterm birth burden at the population level.To explore staff experiences of working with a digital communication platform implemented throughout several primary healthcare centres in Sweden.
A descriptive qualitative approach using focus group interviews. Qualitative content analysis was used to code, categorise and thematise data.
Primary healthcare centres across Sweden, in both rural and urban settings.
A total of three mixed focus groups, comprising 19 general practitioners and nurses with experience using a specific digital communication platform.
Five categories emerged 'Fears and Benefits of Digital Communication', 'Altered Practice Workflow', 'Accepting the Digital Society', 'Safe and Secure for Patients' and 'Doesn't Suit Everyone and Everything'. These were abstracted into two comprehensive themes 'Adjusting to a novel medium of communication' and 'Digitally filtered primary care', describing how staff experienced integrating the software as a useful tool for certain clinical contexts while managing the communication challenges associated with written communication.
Family medicine staff were ambivalent concerning the use of digital communication but, after a period of adjustment, it was seen as a useful communication tool especially when combined with continuity of care. Staff acknowledged limitations regarding use by inappropriate patient populations, information overload and misinterpretation of text by both staff and patients.
Family medicine staff were ambivalent concerning the use of digital communication but, after a period of adjustment, it was seen as a useful communication tool especially when combined with continuity of care. Staff acknowledged limitations regarding use by inappropriate patient populations, information overload and misinterpretation of text by both staff and patients.To synthesise findings from randomised controlled trials (RCTs) of interventions aimed at increasing medication adherence in individuals with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD). And, in a novel approach, to compare the intervention effect of studies which were categorised as being more pragmatic or more explanatory using the Pragmatic-Explanatory Continuum Indicator Summary-2 (PRECIS-2) tool, to identify whether study design affects outcomes. As explanatory trials are typically held under controlled conditions, findings from such trials may not be relatable to real-world clinical practice. In comparison, pragmatic trials are designed to replicate real-world conditions and therefore findings are more likely to represent those found if the intervention were to be implemented in routine care.
Systematic review and meta-analysis.
Ovid Medline, Ovid Embase, Web of Science and CINAHL from 1 January 2013 to 31 December 2018.
RCTs lasting ?3 months (90 days), involving ?200 patients inias Tool to assess study quality.
In this meta-analysis, interventions were associated with a significant increase in medication adherence. https://www.selleckchem.com/products/etomoxir-na-salt.html Overall multifaceted interventions which included an element of education alongside regular patient contact or follow-up showed the most promise. Effectiveness of interventions between pragmatic and explanatory trials was comparable, suggesting that findings can be transferred from idealised to real-word conditions.
CRD42017059460.
CRD42017059460.To estimate the pooled prevalence of women's satisfaction with existing labour and delivery services in Ethiopia.
Systematic review and meta-analysis.
MEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were searched for the study. This meta-analysis included nineteen cross-sectional studies. Cochrane Istatistics were used to check the heterogeneity of the studies. Subgroup and sensitivity analysis were conducted with the evidence of heterogeneity. Egger test with funnel plot were used to investigate publication bias.
Nineteen studies were included in the systematic review and meta-analysis. The overall prevalence of women's satisfaction with existing labour and delivery services in Ethiopia was 70.54% (95% CI 60.94 to 80.15). Having informal education of the women (adjusted OR (AOR)=2.19; 95%?CI 1.47 to 3.25), time to be seen by the healthcare providers within 20?min (AOR=2.97; 95%?CI 2.11 to 4.19), receiving free service (AOR=5.01; 95%?CI 2.87 to 8.75), keeping women privacy (AOR=2.84; 95%?CI 1.46 to 5.55), planned delivery in the health institution (AOR=2.85; 95%?CI 1.99 to 4.07), duration of labour within 12?hours (AOR=2.55; 95%?CI 1.70 to 3.81) and have not antenatal care follow-up (AOR=4.03; 95%?CI 2.21 to 7.35) were factors associated with women satisfaction with labour and delivery services in Ethiopia.
The pooled prevalence of women's satisfaction with existing labour and delivery services was high. Informal education of the women, antenatal care follow-up, planned delivery in the health institution, keeping women privacy, getting free service, time to be seen by the healthcare providers and duration of labour were factors associated with women's satisfaction during labour and delivery services. This finding is important to design strategic policies and to prevent emergency neonatal and women complications during the childbirth and postpartum periods.
CRD42020149217.
CRD42020149217.